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General NPI Number Information
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NPI Number | 1780511964
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Entity Type | Organization
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Legal Business Name | SOUTHEAST PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 407 LINCOLN RD STE 6H-1479
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3020
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Country | US
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Telephone | 718-931-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 4770 WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10470-1136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | SAMUEL KOHN
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Credential |
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Telephone | 718-931-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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